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Physiology > Ch 17: Blood > Flashcards

Ch 17: Blood Flashcards

1
Q

What is the blood comprised of?

A
  1. Plasma
  2. WBC
  3. RBC
  4. Platelets
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2
Q

What are the 3 layers of spun blood?

A
  1. Plasma
  2. RBC
  3. WBC
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3
Q

How much of the blood is plasma?

A

55%

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4
Q

How much of the blood are erythrocytes?

A

45%

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5
Q

How much of the blood are the buffy coat?

A

less than 1%

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6
Q

What is hematocrit?

A

Percent of blood volume that is RBCs

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7
Q

Describe the physical characteristics of blood

A

Sticky, opaque with metallic taste

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8
Q

How does the color of blood vary in the presence of O2?

A

High O2: scarlet

Low O2: dark red

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9
Q

What is the normal pH of blood?

A

7.35-7.45

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10
Q

How much does blood take up body weight?

A

8%

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11
Q

What is the standard volume of blood in males and females?

A

Males: 5-6L

Females: 4-5L

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12
Q

How much water is in blood plasma?

A

90%

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13
Q

What are the components of plasma?

A
  1. Dissolved solutes
  2. 60% albumin
  3. 36% globulins
  4. 4% fibrinogen
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14
Q

Where is plasma produced?

A

Liver

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15
Q

What are the functions of albumin?

A
  1. Substance carrier
  2. Blood buffer
  3. Major contributor of plasma osmotic pressure
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16
Q

Why are WBCs the only complete cell of the blood?

A

RBCs have no nuclei or organelles, and platelets are cell fragments

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17
Q

Describe the distribution functions of the blood?

A
  1. Delivering O2 and nutrients to body cells
  2. Transporting metabolic wastes to lungs and kidneys for elimination
  3. Transporting hormones from endocrine organs to target organs
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18
Q

Describe the regulation functions of the blood?

A
  1. Maintaining body temperature by absorbing and distributing heat
  2. Maintaining normal pH using buffers; alkaline reserve of bicarbonate ions
  3. Maintaining adequate fluid volume in circulatory system
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19
Q

Describe the protection functions of the blood?

A
  1. Preventing blood loss: platelets and clotting

2. Preventing infection: antibodies, WBCs

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20
Q

Describe the structure of erythrocytes

A
  1. Biconcave discs
  2. Anucleate
  3. No organelles
  4. Filled with Hb
  5. Contain plasma membrane protein spectrin
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21
Q

Describe the structure of erythrocytes that contribute to gas transport

A
  1. Biconcave shape give huge suface area relative to volume
  2. > 97% Hb
  3. No mitochondria or ATP production anaerobic so it doesn’t consume O2
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22
Q

What is the major contributing to blood viscosity?

A

RBCs

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23
Q

What is the function of RBCs?

A
  1. RBCs dedicated to respiratory gas transport

2. Hb binds reversibly with O2

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24
Q

Describe the components of Hemoglobin

A
  1. Globin: 2 alpha and 2 beta polypeptide chains
  2. Heme pigment bond to globin
  3. Heme iron center binds to 1 O2
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25
Q

How many Hb molecules are in a single RBC?

A

250 million

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26
Q

How many O2 molecules are transported by a single Hb?

A

4

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27
Q

What occurs during O2 loading?

A

Production of oxyhemoblobin

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28
Q

Where does O2 loading occur?

A

Lungs

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29
Q

What occurs during O2 unloading?

A

Production of deoxyhemoglobin or reducing Hb

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30
Q

Where does O2 unloading occur?

A

Tissues

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31
Q

What occurs during CO2 loading?

A

Formation of carbaminohemoglobin

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32
Q

Where doe CO2 loading occur?

A

Tissues

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33
Q

What is hematopoeisis?

A

Blood cell formation in red bone marrow

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34
Q

What is the purpose for hematopoietic stem cells?

A
  1. Give rise to all formed elements
  2. Hormones and growth factors push cell toward specific pathway of blood cell development
  3. Committed cells cannot change
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35
Q

What occurs when there are too many RBCs?

A

Hypoxia

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36
Q

What occurs when there are too few RBCs?

A

Hypoxia

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37
Q

What dictates RBS production and destruction?

A
  1. Hormonal controls

2. Adequate supplies of Fe, amino acids, and Vitamin B

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38
Q

What controls the production of RBC hormonally?

A

EPO

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39
Q

Where is is EPO released from?

A

Released by kidneys in response to hypoxia

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40
Q

What hormone can enhance EPO production?

A

Testosterone causing higher RBC counts

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41
Q

What are the 3 factors that cause hypoxia?

A
  1. Decreased RBC numbers due to hemorrhage or increased destruction
  2. Insufficient hemoglobin per RBC (e.g., iron deficiency)
  3. Reduced availability of O2 (e.g., high altitudes)
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42
Q

Describe the mechanism to restore homeostasis of blood from hypoxia

A
  1. Hypoxia occurs
  2. Kidney releases EPO
  3. EPO stimulates red bone marrow
  4. Increase in RBC count
  5. O2 carrying ability of RBC rises
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43
Q

What types of dietary requirement are used for erythropoiesis?

A
  1. Nutrients
  2. Iron
  3. Vitamin B12 and folic acid
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44
Q

What is the life span of RBCs?

A

100-120 days

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45
Q

What occurs when heme and globin are separated?

A
  1. Iron is salvaged for reuse
  2. Heme degraded to bilirubin
  3. Liver secretes bilirubin which is degraded by urobilinogen and pigment leaves body in feces as stercobilin
  4. Globin metabolized into amino acids
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46
Q

What happens to RBCs when they get old?

A
  1. Become fragile, Hb begins to degenerate
  2. Gets trapped in spleen
  3. Macrophages engulf dying RBCs in spleen
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47
Q

Describe the lifetime of a RBC

A
  1. Low O2 levels in blood stimulate kidneys to produce EPO
  2. EPO levels rise in blood
  3. EPO promote RBC formation in red bone marrow
  4. Aged and damagesd are engulfed by macrophages and secreted in feces or raw materials are recycled
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48
Q

What is anemia?

A

Blood having abnormally low O2 carrying capacity

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49
Q

What are the symptoms of anemia?

A
  1. Fatigue
  2. Pallor
  3. Shortness of breath
  4. Chills
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50
Q

What causes anemia?

A
  1. Blood loss
  2. Low RBC production
  3. High RBC destruction
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51
Q

Describe how blood loss can cause anemia?

A

Hemorrhaging

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52
Q

Describe how Low RBC production can cause anemia

A
  1. Iron deficiency
    1. Pernicious anemia: Autoimmune deficiency in B12
    2. Aplastic anemia: desctruction of red marrow
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53
Q

Describe how high RBC destruction can cause anemia

A
  1. Hemolytic anemia: Premature RBC lysis due to abnormal Hb
  2. Thalassemia: genetic deficiency of Hb
  3. Sickle cell anemia
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54
Q

What is polycythemia vera?

A
  1. Bone marrow cancer → excess RBCs

2. Severely increased blood viscosity

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55
Q

What is secondary polycythemia?

A
  1. Less O2 available (high altitude) or EPO production increases → higher RBC count
  2. Blood doping
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56
Q

How does sickle cells differ from normal RBCs?

A
  1. Hemoglobin S
  2. RBC is crescent shape where unloading O2 is low
  3. RBCs rupture easily and block small vessels
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57
Q

What causes sickle cell anemia?

A

Glutamate side chain is substituted with valine

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58
Q

What occurs when a person has 2 copies of the sickle-cell gene?

A

Sickle-cell anemia

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59
Q

What occurs when a person has 1 copy of the sickle-cell gene?

A

Milder disease and better chance of surviving malaria

60
Q

How much of the WBC make up the total blood volume?

A

Less than 1%

61
Q

What are the functions of WBC?

A
  1. Can leave capillaries via diapedesis

2. Move through tissue spaces by ameboid motion and positive chemotaxis

62
Q

What is leukocytosis?

A

Increased count of WBC in response of an infection

63
Q

What are the 2 categories of WBC?

A
  1. Granulocytes

2. Agranulocytes

64
Q

What are granulocytes?

A
  1. Visible cytoplasmic granules

2. Lobed nuclei

65
Q

What are the types of granulocytes?

A
  1. Neutrophils
  2. Eosinophils
  3. Basophils
66
Q

What are neutrophils?

A
  1. Most numerous WBCs
  2. Granules contain hydrolytic enzymes or defensins
  3. Very phagocytic—”bacteria slayers”
67
Q

What are eosinophils?

A
  1. Granules lysosome-like
  2. Release enzymes to digest parasitic worms
  3. Role in allergies and asthma
  4. Role in modulating immune response
68
Q

What are basophils?

A
  1. Contains histamines

2. Function similar to mast cells

69
Q

What are histamines?

A

Inflammatory chemical that acts as vasodilator to attract WBCs to inflamed sites

70
Q

What are agranulocytes?

A
  1. No visible cytoplasmic granules

2. Have spherical or kidney-shaped nuclei

71
Q

What are the types of agranulocytes?

A
  1. Lymphocytes

2. Monocytes

72
Q

What are lymphocytes?

A
  1. 2nd most numerous WBC
  2. Found in the lymphoid tissue
  3. Crucial to immunity
73
Q

What are the types of lymphocytes?

A
  1. T cells

2. B cells

74
Q

What are T cells?

A

Act against virus-infected cells and tumor cells

75
Q

What are B cells?

A

Give rise to plasma cells which produce antibodies

76
Q

What are monocytes?

A
  1. Largest leukocytes
  2. Enter tissue and differentiate into macrophages
  3. Actively phagocytic cells; crucial against viruses, intracellular bacterial parasites, and chronic infections
  4. Activate lymphocytes to mount an immune response
77
Q

What is the production of WBCs called?

A

Leukopoiesis

78
Q

What are the chemical messengers that stimulate WBC production?

A
  1. Interleukins

2. Colony-stimulating factors

79
Q

What is leukopenia?

A

Abnormally low WBC count

80
Q

What is leukemia?

A

Cancer → overproduction of abnormal WBCs

81
Q

What is infectious mononucleosis?

A
  1. Caused by the Epstein-Barr virus
  2. High numbers of atypical agranulocytes
  3. Tired, achy, chronic sore throat, low fever
82
Q

What are platelets?

A

Cytoplasmic fragments of megakaryocytes that form temporary platelet plugs to seal blood vessels

83
Q

What regulates platelet formation?

A

Thrombopoeitin

84
Q

How are platelets stay inactive?

A

Nitric oxide and prostacyclin

85
Q

When would platelets degenerate?

86
Q

Is a thrombocytes a platelet?

87
Q

What is hemostasis?

A

Fast series of reactions for stopping bleeding

88
Q

Describe the steps of hemostasis

A
  1. Vascular spasm: smooth muscle contracts causing vasoconstriction
  2. Platelet plug formation: injury to lining of vessel exposes collagen fibers, platelets adhere
  3. Platelets release chemicals that make nearby pllatelets sticky, forming platelet plug
  4. Coagulation: fibrin forms a mesh that traps RBCs and platelets forming clots
89
Q

What are the triggers for vascular spasm in hemostasis?

A
  1. Direct injury to vascular smooth muscle
  2. Chemicals released by endotheilial cells and platelets
  3. Pain reflexes
90
Q

What is the von Willebran factor?

A

Platelets stick to collagen fibers via plasma protein

91
Q

What happens to a platelet when the plug forms?

A
  1. Swell
  2. Spiked
  3. Sticky
  4. Release chemical messengers
92
Q

What kind of chemical messengers are released by platelets during clotting?

A
  1. ADP

2. Seratonin and thromboxane

93
Q

How does ADP help clotting?

A

Causes more platelets to stick and release contents

94
Q

How do Seratonin and thromboxane help clotting?

A

Enhance vascular spasm and platelet aggregation

95
Q

What are the phases of coagulation?

A
  1. Prothrombin activator formed in both intrinsic and extrinsic pathways
  2. Prothrombin converted to enzyme thrombin
  3. Thrombin catalyzes fibrinogen to fibrin
96
Q

Describe phase 1 of coagulation

A
  1. Triggered by tissue damage events
  2. Involve a series of procoagulants
  3. Each pathway cascades toward factor X
  4. Factor X complexes with Ca2+, PF3, and factor V to form prothrombin activator
97
Q

What is the intrinsic pathway?

A
  1. Triggered by negatively charged surfaces (activated platelets, collagen, glass)
  2. Uses factors present within blood (intrinsic)
98
Q

What is the extrinsic pathway?

A
  1. Triggered by exposure to tissue factor (TF) or factorIII (an extrinsic factor)
  2. Bypasses several steps of intrinsic pathway, so faster
99
Q

Describe phase 2 of coagulation

A
  1. Prothrombin activator catalyzes transformation of prothrombin to activate thrombin
  2. Once activator is formed, clots form in 10-15 seconds
100
Q

Describe phase 3 of coagulation

A
  1. Thrombin converts soluable fibronogen to fibrin

2. Thrombin with Ca2+ activates facotr XIII which cross-links fibrin and strengthens and stabilizes clot

101
Q

What occurs during clot refraction?

A
  1. Stabilizes clot
  2. Actina and myosin in platelets contract withing 30-60 minutes
  3. Contraction pulls on fibrin stands, squeezing serum from clot
  4. Draws ruptured blood vessel edges together
102
Q

What hormones drive vessel repair?

A
  1. Platelet derived growth factor (PDGF)

2. Vascular endothelial growth factor (VEGF)

103
Q

What does the PDGF stimulate?

A

Division of smooth muscle cells and fibroblasts to rebuild blood vessel wall

104
Q

What does the VEGF stimulate?

A

Endothelial cells to multiply and restore endothelial lining

105
Q

What is fibrinolysis?

A

The removal of unneeded clots after healing

106
Q

What occurs during fibrinolysis?

A

Plasminogen in clot is converted to plasmin by tPA, fator XII, and thrombin

107
Q

What enzyme digests fibrin?

108
Q

What are the 2 mechanisms that limit clot size?

A
  1. Swift removal and dilution of clotting factors

2. Inhibition of activated clotting factors

109
Q

What binds to fibrin threads?

110
Q

What inactivates unbound thrombin?

A

Antithrombin III

111
Q

What inhibits thrombin by enhancing antithrombin III?

112
Q

What prevents platelet adhesion?

A
  1. Smooth endothelium of blood vessels prevents platelets from clinging
  2. Antithrombic substances nitric oxide and prostacyclin secreted by endothelial cells
  3. Vitamin E quinone acts as potent anticoagulant
113
Q

What is thrombus?

A

Clot that develops and persists in unbroken vessel

114
Q

What is an embolus?

A

Thrombus freely floating in blodstream

115
Q

What is an ebolism?

A

Embolus obstructing a vessel

116
Q

What are the risk factors of undesirable clotting?

A
  1. Atherosclerosis
  2. Inflammation
  3. Slowly flowing blood or blood stasis from immobility
117
Q

What is thrombocytopenia?

A

Deficient number of circulating platelets

118
Q

What is hemophilia A, B, and C?

A

Prolonged bleeding disorder

119
Q

What is impaired liver function?

A
  1. Inability to synthesize procoagulants
  2. Causes include vitamin K deficiency, hepatitis, and cirrhosis
  3. Impaired fat absorption and liver disease can also prevent liver from producing bile, impairing fat and vitamin K absorption
120
Q

What is DIC?

A
  1. Clotting causes bleeding
  2. Widespread clotting blocks intact blood vessels
  3. Severe bleeding occurs because residual blood unable to clot (due to consumption of platelets)
121
Q

When would you uses whole-blood transfusions?

A

Blood loss both rapid and substantial

122
Q

When would you uses packed-blood transfusions?

A

To restore oxygen-carrying capacity

123
Q

What is the role of antigens in RBC?

A
  1. Anything perceived as foreign; generates an immune response
  2. Promoters of agglutination; called agglutinogens
124
Q

What happens when blood transfers are mismatched?

A
  1. May be agullated and destroyed

2. Can be fatal

125
Q

What are the antigen classifications of RBC?

126
Q

What are agglutinins?

A

Anti-A or B antibodies

127
Q

How are Rh factors inherited?

A

Anti-Rh antibodies form if Rh– individual receives Rh+ blood, or Rh– mom carrying Rh+ fetus

128
Q

What is erythroblastosis fetalis?

A

Only occurs in Rh– mom with Rh+ fetus

129
Q

What is RhoGAM?

A

Serum containing anti-Rh can prevent Rh- mother from becoming sensitizes

130
Q

What heolytic disease can occur during the second pregancy?

A

Mom’s anti-Rh antibodies cross placenta and destroy RBCs of Rh+ baby

131
Q

What is donor’s cells?

A
  1. Attacked by recipient’s plasma agglutinins
  2. Agglutinate and clog small vessels
  3. Rupture and release hemoglobin into bloodstream
132
Q

What are the results of donor’s cells?

A
  1. Diminished oxygen-carrying capacity
  2. Diminished blood flow beyond blocked vessels
  3. Hemoglobin in kidney tubules → renal failure
133
Q

What are the treatments for donor’s cells?

A

Preventing kidney damage by flushing fluids and diuretics to wash out hemoglobin

134
Q

What is the universal donor?

A

O becuase no presence of A or B antigens

135
Q

What is universal recipient?

A

AB because they contain no anti-A or anti-B antibodies

136
Q

What is the term for patients pre-donating blood?

A

Autologous transfusion

137
Q

How is blood typing achieved?

A
  1. Mixing RBCs with antibodies against its agglutinogen(s) causes clumping of RBCs
  2. Done for ABO and for Rh factor
138
Q

How is blood cross matching achieved?

A
  1. Mix recipient’s serum with donor RBCs

2. Mix recipient’s RBCs with donor serum

139
Q

What can occur when a person has extremely low blood volume?

A

Death from shock

140
Q

How is volume replenished when extreme blood loss occurs?

A
  1. Normal saline or multiple-electrolyte solution (Ringer’s solution) that mimics plasma electrolyte composition
  2. Plasma expanders
141
Q

What are platelet expanders?

A
  1. Mimic osmotic properties of albumin

2. More expensive and may cause problems

142
Q

What tests for anemia?

A

Hematocrit

143
Q

What tests for diabetes?

A

Blood glucose tests

144
Q

What is the purpose of microscopically examining blood?

A
  1. Reveals variations in size and shape of RBCs, indications of anemias
  2. Differential WBC count
145
Q

How can we assess hemostasis?

A

Prothrombin time and platelet counts

146
Q

What is SMAC?

A

Blood chemistry profile for kidney and liver disorders

147
Q

What does a complete blood count achieve?

A

Checks formed elements, hematocrit, and hemoglobin

Physiology (22 decks)

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